Abstract

The low participation level of rural women in cancer screening is a cause of concern especially in India. The role of predisposing knowledge and attitudes concerning cancer in many religious and ethnic groups is not studied well to find out cause of such reluctance in participation. We documented the knowledge and fears concerning such cancer in rural population of women of different ethnicity and religions in West Bengal province of India and how these factors relate to screening behaviour and socio-demographic characteristics. A baseline survey was conducted before the start of a community cancer awareness and screening programme. A total of 2000 rural women of different districts of West Bengal were interviewed in-person about their knowledge, attitudes and Pap smear and mammogram screening practices. Knowledge and attitude about cancer varied with age, education, socioeconomic status, ethnicity and religion. Women in the age range of 40–72 years (median 56 years) and least knowledgeable of cancer-detection methods and screening guidelines were considered for our study. Socio-economic markers were monthly income, literacy, nature of roof, and toilet. About 80% women, who participated, had no toilet facility. Women, who could not read and write, were more unaware of cancer signs and symptoms, risk factors and screening guidelines. However, biggest concern about was poor infrastructural facility for doing cervical examination and women are shy to have elaborate examination and treatment in their private parts in an open camp. Striking finding was full participation and cooperation in awareness and screening of cervical cancer among scheduled tribal women. They had near total participation which was far more than scheduled casts and Muslims. The low screening participation among rural Indian women may be due to their shyness to participate in a comparatively open camp and limited awareness and knowledge about screening examinations. Our study highlights the need for wide-scale cancer screening interventions consistent with prevailing rural belief. Tribal people are most cooperative among all ethnic and religious and socio-economic groups.